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PFI2019-00134
CITY OF TIGARD1111. PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12019 00134 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 04/24/2019 T[G A R D Parcel: SEG885 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Comcast Project Description: SEG 885/12175 SW 124th Ave. Comcast proposes to bore to place(2)-2"conduits for a total of 160' while maintain a depth of 36"within the City of Tigard ROW. Owner: FEES Description Date Amount PFI Permit Fee 04/24/2019 $300.00 PHONE: Contractor: TEXSTAR ENTERPRISES INC 17090 JORDAN RD SELMA, TX 78154 PHONE: 210-656-8775 FAX: Applicant: ALEX SILANTIEV 11308 SW 68TH PARKWAY TIGARD, OR 97223 PHONE: 503-596-3733 Total $300.00 Please sign below to indicate acceptance of conditions and return a copy with the proposed work schedule along with names and contact information of responsible parties before beginning work. PermitteelApplicant ti Signature: �e� pUCd7vvti. Issued By: Arj Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PFI2019-00134 Type: Condition Name: Status: Severity: PFI_Utilities 01 -WORK SITE REQUIREMENTS Applied Notice Applicant must comply with all applicable provisions of federal and state law, the Tigard Municipal Code, and the terms of any agreement with the City of Tigard regarding work to be done pursuant to this permit. PFI_Utilities 02-WORK SITE AREA Applied Notice The work area and approach roads shall be maintained in a clean condition, free from obstructions and hazards. The spreading of mud or debris or storage of materials or equipment of any kind upon any public roadway is strictly prohibited and violation shall be cause for immediate cancellation of the permit. The City may at any time order immediate clean-up and suspension of work to accomplish clean-up. PFI_Utilities 03-WORK SITE EROSION CONTROL Applied Notice Prior to starting work, effective and approved erosion control devices must be installed and maintained meeting the Clean Water Services and DEQ requirements. The City may at any time order corrective action and suspension of work to accomplish effective erosion control. PFI_Utilities 04-WORK SITE REPAIRS Applied Notice Disturbed landscaped areas shall be restored or replaced. Existing signs, pavement markings, mailboxes, etc. shall be reinstalled or replaced,with like kind of material. Obtain City approval of restoration work. PFI_Utilities 05-TRAFFIC CONTROL SPECIFICATIONS Applied Notice Applicant shall provide traffic control according to the current edition of the"Manual on Uniform Traffic Control Devices [MUTCD]for Streets and Highways", U.S. Dept. of Transportation, FHWA, current edition, American Traffic Safety Services Association[ATSSA], and Oregon Temporary Traffic Control Handbook[OTTCH]. PFI_Utilities 06-TRAFFIC CONTROL PLAN Applied Notice Submit a job specific traffic control plan. A copy of the approved traffic control plan shall be readily available at the work area. Traffic control devices, flag persons, etc.,shall be in place prior to initiation of construction work and shall be effectively maintained. PFI_Utilities 07-TRAFFIC CONTROL ROAD CLOSURE Applied Notice Public roadway shall not be closed to traffic, at any time,without obtaining written approval from the City Engineer. The applicant is responsible to provide 48 hour advance notice of traffic flow disruptions to affected businesses, residents and area wide Emergency Services: 503-629-0111 (Tigard Police Dept., Tualatin Fire& Rescue)and to 503-962-8140(Tri-Met) and 503-431-2345(Tigard School District)and other service providers impacted by such closure. PFI_Utilities 08-TRAFFIC CONTROL ADVANCE WARNING Applied Notice Advance warning of traffic disruption shall be provided to the public by placement of an approved advance notification sign at each end of the construction area 72 hours(min.)before initiation of construction work. PFI_Utilities 09-TRAFFIC CONTROL PROPERTY ACCESS Applied Notice Access to existing properties shall be maintained at all times, including normal delivery service and mail service. Obtain City approval of any access closures. PFI_Utilities 10-TRAFFIC CONTROL WORK HOURS Applied Notice Work is permitted in daylight between the hours of 7:00 a.m. to 7:00 p.m. Mon-Fri unless otherwise authorized by the City. PFI_Utilities 11 -TRAFFIC CONTROL LIMITED WORK HOURS Applied Notice Hours of construction work on collector and arterial roads will be limited to 9:00 a.m.to 3:00 p.m. unless authorized by the City Engineer. Work will not be permitted on collector and arterial roads between 3:00 p.m. to 9:00 a.m. unless authorized by the City Engineer. PFI_Utilities 12-TRAFFIC CONTROL MODIFICATION Applied Notice The City reserves the right to add to or modify traffic control requirements as necessary to effectively control traffic and to assure public safety. PFI_Utilities 13-DRAINAGE CONTROL Applied Notice Drainage shall be controlled within the work site and shall not adversely affect adjacent private property, public property and the receiving system. The City may at any time order corrective action and suspension of work to accomplish effective drainage control. PFI_Utilities 14-UTILITY NOTIFICATION Applied Notice Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR 952-001-0100 through OAR 952-001-0080. Copies of said rules may be obtained from the Center by calling 503-246-1987. If you have any question about the rules, contact the Center. NOTE: Damage to utilities shall be corrected at the permit holder's expense. PFI_Utilities 15-UTILITY LOCATION CONFLICT Applied Notice Applicant must verify all existing utilities for both vertical elevation and horizontal location prior to start of work(pothole before digging if necessary). Should conflicts arise and redesign or relocation of facilities be necessary, it shall be done at the applicant's expense. Changes must be approved by the City in advance of work.Applicant shall coordinate the work with affected utility agencies. PFI_Utilities 16-TEMPORARY PATCH Applied Notice A temporary hard-surface patch shall be placed on trenches within roadways at the end of each work shift. Obtain advance approval of patching method. No trench shall be left at any time in an un-safe condition. Applicant is responsible for and is liable for hazards or damage resulting from the prosecution of the work. PFI_Utilities 17-REPAIR OF EXISTING FACILITIES Applied Notice Work under this permit shall include repair of existing facilities(roads, ditches,etc.)as may be necessary, as determined by the Inspector, to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit. Corrective work shall be done at the applicant's expense. PFI_Utilities 19-PRECONSTRUCTION MEETING Applied Notice Before initiating any construction activity,the applicant shall coordinate with the City's inspector, <Insert Name>at<Insert Phone#>, to establish a preconstruction meeting. PFI_Utilities 20-NOTICE TO COMMENCE WORK Applied Notice The applicant shall notify the City's Inspector twenty-four(24)hours prior to commencing work, prior to any staged inspection, and after completing work covered by the permit. PFI_Utilities 21 -PERMIT/PLAN ON SITE Applied Notice A copy of the permit including a Certificate of Insurance, and all attachments, and a copy of the approved construction plan and all amendments shall be readily available at the work area. All work shall conform to the permit terms, conditions and provisions and to the City approved permit plans, and approved plan amendments and to the City's standards and specifications and to these General Conditions. Changes to any of these must be approved by the City, in advance of work performance. PFI_Utilities 22-DAILY INSPECTION REPORTS Applied Notice Applicant shall submit daily inspection reports, on a weekly basis,to the City's Inspector. PFI_Utilities 23-MONUMENT PROTECTION Applied Notice Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holder's expense. PFI_Utilities 24-VALIDATION OF MATERIAL/CONSTRUCTION Applied Notice The City's Inspector may, at his discretion, require tests and or reports from the applicant to validate claims of material or construction adequacy/compliance. Such tests/reports shall be provided at the applicant's expense. PFI_Utilities 25-EMERGENCY CONTACTS Applied Notice Provide to the City inspector, in writing, the names and 24 hour emergency telephone number of two(2)persons who have authority to resolve problems,take corrective action and, in general, will be responsible in case of any emergency. The applicant shall notify the City Inspector, in writing, of any/all assignment changes. PFI_Utilities 26-RIGHT OF ENTRY/EASEMENTS Applied Notice Applicant to obtain proper right-of-entry and/or easements prior to starting work. Proof of right-of-entry or properly executed easements, shall be provided to the City. The City shall in no way be construed to be liable for the applicant's failure to obtain or provide for proof of right-of-entry or easements. PFI_Utilities 27-PRIVATE PROPERTY AGREEMENTS Applied Notice Provide the City a copy of an executed agreement[s]from the owner for each private property disturbed by construction activity. PFI_Utilities 28-AS-BUILT DRAWING Applied Notice 1,2,3,4,5 28-AS-BUILT DRAWING One as-built drawing showing all new public improvements, including any revision made to the previously approved construction plans and, also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineer's certification of installation compliance(Certificate of Compliance). 1,2,3,4,5 28-AS-BUILT DRAWING One as-built drawing showing all new public improvements, including any revision made to the previously approved construction plans and, also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineer's certification of installation compliance(Certificate of Compliance). One as-built drawing showing all new public improvements, including any revision made to the previously approved construction plans and, also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineer's certification of installation compliance(Certificate of Compliance). PFI_Utilities 31 -OTHER Applied Notice Other RECEIVED City of Tigard APR 2 2 2019 11111 PUBLIC WORKS --ENGINEERING CITY OF TIGARD ! ANNING/ENGINEERING - Public Facility Improvement (PFI - ermit TI(;ARI) TY )F WORK DESCRIPTION OF WORK(in the right-of-way) ❑ TYPE 1- , uclnise Utility Work Check one: D Utilities LI Sidewalk/driveway approach ❑Streetimprovements performed by NWN, PGE Detailed description: Comcast proposes to bore to place(2)-2"conduits for a total of and/or utilir!-agency. 160'while maintaining a depth of 36"within City of Tigard right of way. C1 TYPE 2—: calk/Driveway/Sewer Work perfo_1;1ed for the purpose of: • Sidewall• ;tallation or repair. 12175 SW 124th Ave,Tigard, OR 97223 • Driveway c.pproach installation Property address/location(s): and/or repair. S l - • Sanitary sewer lateral installation and/or main line tap Ci Comcast Cable Communications Management,LLC TYPE 3—Full scale Development Applicant: Work performed with Land use Address: 11308 SW 68th Parkway approval which includes any of City/state: Tigard, OR Lip: 97223 the following: Phone: (503)596-3733 Email: Alexander_Silantiev©comcast.com • Subdivisions or Partitions Contact name: Alex Silantiev Phone: • Street widening • Mainline installation for Sanitary Contractor: Texstar Enterprises sewer, Storm sewer,Tigard water and/or Tigard Water Service Area CCB#: 178798 Expiration: 10/10/2019 Address: 14122 Arndt Rd SUBMIT COMPLETED APPLICATION TO: City/state: Aurora,OR Zip: 97002 City of Tigard Planning/Engineering Phone: (503)793-3109 Email: 13125 SW Hall Blvd. Contact name: Jim Miner Phone: Tigard,OR 97223 Applications for"minor work in right-of-way" only may be emailed to: Engineer: rowpermitsaa,tigard-or.gov Address: root STAFF USE ONLY City/state: Zip: Phone: Email: Case No.: PF taO Cg-00k 3'-i Contact name: Application submittal fee(.007%of Engineer's Estimate) $ Estimated value of work is required(if over$5,000):$ Additional fees:$ -31X> (within the public right-of-way) Application accepted: By: Date: y 124C\ Is work related to a LAND-USE DECISION? ❑ Yes ❑ No Application reviewed: If so,please specify(MLP,SDR,SUB,etc.) case#: By: 53 Date: A 2 3 l Is work related to a BUILDING PERMIT? ❑ Yes ❑ No Applicant notified: If so,please specify(BUILDING PERMIT)case#: By: A...- Date: ti`L3 1(1 I:\ENG\PermitApplications\pfi_application Rev.10/16/2017 t L City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of APPLICANTS NOTE: Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for work,if required by the city pursuant to TMC 15.041.140. * With the exception of a utility operating pursuant to a valid franchise with the City of Tigard,when the owner and the applicant are different people,the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner or an agent of the owner. The owners)must sign this application in the space provided or submit a written authorization with this application. Franchised Utilities arc not required to obtain the owner's signature on the application BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT: • The above request does not violate any recorded deed restrictions that maybe attached to or imposed upon the subject property. • If the application is granted,the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. • All of the above statements and the statements in any plot plan,attachments,and exhibits transmitted herewith,are true;and the applicants so acknowledge that any permit issued,based on this application,may be revoked if it is found that any such statements are false. • The applicant has read the entire contents of the application,including the policies and criteria,and understands the requirements for appro'' _or.enying the application. .G*.I Corey Dunston 4-18-19 Ap•.(•'n /Authorized Agent's signature Print name Date SIGNATURES of each owner of the subject property, if required. Owner's signature Print name Date Owner's signature Print name Date Owner's signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 2 of 4 DEVELOPMENT ENGINEERING FEES FOR STAFF USE ONLY Public Facility Improvement(PFI)Permit: DETAILED SUBMITTAL REQUIREMENTS APPLICATION FEE Part 1: Required submittal fee$300.00 (minimum) FRANCHISE UTILITY AND SIDEWALK/ DRIVEWAY AND UTILITY PERMIT FEE CONNECTIONS,ETC. Part 2: All non-water system improvements (work in the right of way) Engineer's estimate X 5%(less$300.00 minimum submittal fee) Sketch Engineer's estimate X 2%Plan Review (including information below) ❑ Dimensions WATER SYSTEM FEE ❑ Street Name Part 3: All public water system improvements ❑ Site Address Engineer's estimate X 12% FULL SCALE DEVELOPMENT PFI Permit Fee Exemptions: (Subdivisions/Partitions and Street Improvements) There will be no permit fee charged,or assurance required for the followingtypes of work: Design Plans (6 sets,24x36 or 22x34) • Sidewalk repair(less than 20 lineal feet) • Relocate or replace mailbox ❑ Cover—Site,Vicinity,Abbreviation,Legend • Ditch cleaning that does not involve regrading. ❑ General Notes(City,Water,Sewer,etc.) • Weep hole repair ❑ Street(Plan,Profile) • Curb repair or replacement(less than 20 lineal feet) ❑ Water,Storm and Sanitary(Plan Profile) • Lawn sprinkler system installation or repair ❑ Water Quality Facilities • Street tree pruning or planting ❑ Grading • Planter strip landscape maintenance ❑ Landscaping/Tree Plan • Test wells ❑ Composite Utility Plan(Electrical,Phone,Gas, Storm,Sanitary,Water,Signage,Street Lights,etc) ❑ Details Note: A cash/bond assurance may be ❑ Traffic Sight Distance required per TMC 15.04.140. ❑ Signing and Striping (customer deposit) ❑ Street Light Plan and Photometric ❑ Engineers seal/signature ❑ Sheet label(project land use name,revision and plan log block,dates and sheet numbers.) Additional Submittals (per Land Use conditions) ❑ Traffic Report ❑ Storm water Drainage Calculations ❑ Geotechnical Report ❑ Preliminary Access Report(Sight Distance) • ❑ Proposed Plat ❑ Pathway Design(if applicable) ❑ Water Department Approval ❑ Engineer's Construction Estimate PUBLIC FACILITY IMPROVEMENT PERMIT City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 3 of 4 I I I I 1 I I 1 1 / ii 4 nPpN T j N A iq ii ) ;I _sir, if -- 'I 260'FROM SW KATHERINE ST FOC , CI � I OW I ROW ROW °p I 'ROW ROW----R0 ROW ROW –10 111 1,04,„--------1,0,17. pW ' � F� F� FOC FOC • S� S� FOC FOC 3� pc_ y FOC— — — s —`, c�=—c —c/� SW 124TH AVE c/L s�-4—c/L c/� E f ---- Zi _ -� ON / I1 /1— — M M G�� FpC��FOC FOC FOC FOC FOC • OC fOC / IN 0,-----"---------;,------"" S/W S/W S S/WROW ROW ROW ROW SAY S/W S/W � pW� ROW ROW ROW FO'' 514/ //ao* i l' FcP 51 ZZv° 8 ,I47 N \ N N N N N 8 N iI1I{ \ N 11111 8/ il 1 N 5.5.t o 1 1 3 I 5 8 o 2 „ a N ,, n qt 4:1 DESIGN BY K J J)EQ#ICAL SOLUTIONS 12175 SW 124TH AVE °"'� °EB`"P'p" °E'0M°A"'�" TIGARD,OR 97223 1 CO MCAST �,° uJLE/ceEnawrnBxrealoNC.D. .� TECHNICAL SOLUTIONS 64687 Contact Alex 41-8Slan5 PO SOX 2529.CMdwnJB.OR 97015 Phone:(503)941 8656 p _(503)g�ep41 CABLE/FIBER PLANT EXTENSION Alex_Silantiev@comcast.com Email:corey_OunsronOkbmalnet CITY OF TIGARD ROW PERMIT DRAWING § ( 2 § ) § k F ! B §kk § dd § \ § i \ § ,10,i.) m . , i - q 33 -$: k ; k k gq - a § g' ? ;) 7 k G » . § 2 i 2 k � ( % / p ) k 2 \ i . / - ` 4 5 k Q « ` § m z i 2 & R _ 1 \ _ ] , ! E . ; B ■ § f ■ . 1 I } X B F ri m r k 4 \ ( ? 2 § 7 q ) 7 m ® 5 sli k 0 { m m $ $ ~ NI / f ) ) § c ¢ I 1Z l ■ 0 • x M » Y c IL? ;} o ._ § § H4 | | 2 4?fr _ DESIGN .,_..SOLUTIONS 2,a S&,aTH�E � ■ COMCAST I 1 , ,_» -_ pcRDO9g2 ' JLA �_m a_ _e___ e c•I§ 6 i 2 Contact:Aixs, n- m 2529,Clackamas.m_a 64687 Phone:Am®, # .c 950-6041 CABLE/FIBER PLANT Expqo Alex_Silantiev@corncast.com Email,C D_ m . - . . LEGEND&TYPICALS Page 84 2011 Edition Stationary Lane Closure with Flagging Diagram 320 2 Diagram 320 covers total closure of one lane of a two-lane, two-way J roadway. See the detail inset for the layout if using a single flagger to control both directions of traffic on low volume roads (less than 400 ADT)with good sight distance as discussed below. 1. Use truck-mounted flashing warning lights on work and protection vehicles. See Section 4.3—Lights and Lighted Signs for exceptions. 2. For added visibility, a truck-mounted arrow board or PCMS in caution mode may be used. 3. Flaggers at each approach are required if any of the following conditions exist: a. Night Operations. b. Work space is over 200 feet in length. c. Sight distance is less than 750 feet from each approach through the lane closure. d. Traffic volumes are greater than 400 ADT. 4. The length between the Flagger Ahead signs shall not exceed one mile. Use Diagram 340— Lane Closure with Pilot Car if exceeding one mile. 5. Cones should be used to outline the work space when curves or other roadway alignments prevent clear direction for the motorists to pass the work space safely. 6. Cones along the work space are recommended when posted speeds are 45 mph or greater, when working under heavy traffic or when travel lanes are narrower than 11 feet. 7. Extended queue signing (see Diagram 5-4) should be used when traffic queues extend beyond the initial advance warning sign. 8. When flagging near an intersection, the"Flagger Ahead" (CW23-2) sign should be visible to traffic entering from any side road. Additional advance warning and Flagger Ahead symbol signs may be placed on the side road(s). 9. Sign set-up and flagger placement shown may be used for intermittent full road closures of 20 minutes or less. 10. The"ONE LANE ROAD AHEAD" (W20-4) sign is optional and should be considered on high volume or high speed roads, or when extended queues are expected. Chapter 5 September 2016 2011 Edition Page 85 N Stationary Lane Closure with Flagging Diagram 320 SDN / co /o 0¢ C 0 0 W C �< ?�Q 0 f:s O 0 PM 43 o, CD CD,,, $ t al CC 0 / 0 ma Clir_j fil '\ 1 * i F— • N c 1. —A •• :c t.- CO • C O CO 156 V'. o l t m t in ai— ® �- I E 3 • I . I . • c > 0 .. . aio II: • < , a) 6 v1/ •-1 wLLI a• �0 C iT) 1 v— Mm j NT,9_ - ml Sign Spacing and Buffer Lengths(feet) Posted Spacing Between Signs "Buffer t �p CO Speed A 8 C Space 0 Q 2 _O 20 50 _ Zj QKL 25 100 100 100 75 �V 30 100 35 125 350 350 350 40 150 0 Y 9 45 180 Q0 0= 50 500 500 500 210 CC 3 Q 55 250 60 285 65 700 700 700 325 70 365 September 2016 Chapter 5 a Page 80 2011 Edition 5.3 Two-Lane, Two-Way Roads a) Shoulder Work w/ Minor Road Encroachment Diag. 300 Use this detail for non-freeway work which extends into a travel lane and maintains a minimum 10 foot travel lane. If a minimum 10 foot travel lane cannot be maintained, or when traffic cannot safely pass by in both lanes simultaneously, use the appropriate lane closure diagrams—for example, Diagrams 310 through 350. A lane closure may be appropriate for conditions such as high traffic volumes, high speeds, and inadequate approach sight distance to the work space, or heavy equipment adjacent to the travel lane. 1. Use truck-mounted flashing warning lights on work and protection vehicles. See Section 4.3—Lights and Lighted Signs for exceptions. 2. For added visibility, a truck-mounted arrow board or PCMS in caution mode may be used. 3. Cones shall be placed along the entire length of the work space. If a protection vehicle is used and work is in place one hour or less, the taper and tangent devices may be omitted. 4. If the speed is 45 mph or higher, volumes exceed 2000 ADT, or there is limited sight distance, consider placing cones or tubular markers on centerline. 5. An arrow board in caution mode or truck-mounted PCMS with "SHOULDER WORK" or other appropriate message may be used for higher visibility. Sign Spacing and Buffer Lengths(feet) Posted Spacing Between Signs "Buffer" Speed A B C Space 20 50 25 100 100 100 75 30 100 35 125 350 350 350 40 150 45 180 50 500 500 500 210 _ 55 250 60 _ 285 65 700 700 700 325 70 _ 365 Chapter 5 September 2016 2011 Edition Page 81 N Shoulder Work wl Minor Road Encroachment Diag. 300 � N ROAD WORK 4 AHEAD/ f" 1 • • Initial Warning A • Sign • • j • (Optional) • • • • Rai • • `U • III Protection Vehicle • wl TMA(both Optional) See Chapter 4 • Buffer � I • 10' • minimum • U3 • I A ROAD NARROWS (Optional) B ROAD WORK AHEAD Initial Warning Sign September 2016 Chapter 5